Its not 50, but (>)50, its like saying LDL >130 is associated with higher risk. Of course, the higher the value the higher the risk. The Novartis trial will use >70 mg/dL, which represents 15% of population at risk, ~1B. Point is no matter what metric you use, it a huge number.
Note also, the >50 mg/dL is in patients on statins, ncbi.nlm.nih.gov/pubmed/30293769. In subjects not on statins risk starts at >30 mg/dL (>75 nmol/L) Old papers show this and see most recent Madsen et al in subjects without prior event: ahajournals.org/doi/abs/10.116…
Madsen data: MACE incidence rates per 1000 person-years were 29 for individuals with Lp(a)<10 mg/dL, 35 for 10 to 49 mg/dL, 42 for 50 to 99 mg/dL, and 54 for ≥100 mg/dL. I think above 10-30 mg/dL one can consider risk fairly linear, like LDL-C.
Rates are higher in subjects with prior events, see FOURIER highest quartile of Lp(a) >120 nmol/L mg/dL (~>50 mg/dL) MACE rate is 10.1% in 3 years, or ~3.3% per year. In above analysis this would equate to 333 events per 1000 yrs. ahajournals.org/doi/pdf/10.116…
This is not trivial
This is not trivial
